Back Pain Boot Camp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3203 Issued in OK

Legal business name

BACK PAIN BOOT CAMP

Practice address

920 S Elm PL
Broken Arrow, OK 74012-5372

Phone

(918) 258-2225

Fax

(918) 251-6624

NPI assigned

Feb 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Darrick Davis, DCNPI 1447347752

Title

Owner

Phone

(918) 258-2225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darrick Davis, DC

  • Chiropractor
  • Broken Arrow, OK
  • NPI 1447347752
  Medicare reassignment NPD Authorized official
• Craig Alan Day, CHIROPRACTOR

  • Chiropractor
  • Tulsa, OK
  • NPI 1730138124
  NPD (past)
• Sean O. Riley, D.C.

  • Chiropractor
  • Tulsa, OK
  • NPI 1992897920
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1891963807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125372",
            "telephone_number": "918-258-2225",
            "fax_number": "918-251-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125372",
            "telephone_number": "918-258-2225",
            "fax_number": "918-251-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK PAIN BOOT CAMP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DARRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-258-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Joyce Avery, O.T.A.
• Emily Ayala
• Ba Eye Site, PLLC
• Ba Vision
• Phebian Arinola Babalola
• Back to Basics Chiropractic., PLLC
• Schuyler J Backlar
• Suella K Baggett, BSPT
• Kelly Elizabeth Bailey, PT
• Gabriel K Bainesai

• All providers in Broken Arrow, OK
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.